Florida judge rules against health overhaul

By gerencherk

A contested feature of the new health-reform law that’s considered important for its success appears headed for the Supreme Court after a Florida judge ruled that it was unconstitutional and as similar cases wind their way through the courts. But consumers won’t see any immediate changes to their health benefits. The new protections delivered by the Affordable Care Act remain intact pending appeal, experts say, though they could be at risk if future decisions go the way of Monday’s ruling.

Conservative governors and state attorneys general in 26 states have taken issue with the part of the multifaceted health overhaul that requires Americans to carry health insurance or face a tax penalty starting in 2014. That provision is generally known as the individual mandate or individual responsibility component, and opponents say it violates the Constitution by allowing Congress to compel the purchase of health insurance. On Monday, a federal judge in Pensacola, Fla., U.S. District Judge Roger Vinson, agreed with them, declaring in a 78-page opinion that it is unconstitutional and raising the political stakes as states prepare to implement the law.

The issue has served as a lightning rod in a nation divided largely along party lines on how and whether to restructure the health system to extend coverage to more of the 50 million uninsured and to address rapidly rising costs. Consensus on the individual mandate’s lawfulness is as split as public opinion. Two other federal judges have upheld the Affordable Care Act’s constitutionality, and one besides Vinson has ruled against it. Twelve others have dismissed cases challenging its constitutionality.

Senior administration officials speaking on background Monday characterized Vinson’s ruling as out of step with the mainstream of judicial opinion and said they’re confident it won’t stand. See the White House blog for its perspective.

So far there’s no statement from America’s Health Insurance Plans, the major trade group of health insurers. Contrary to Republicans’ opposition to the individual mandate, many health insurers have pushed for it not only to exist, but to be enforced when healthy people especially don’t buy coverage. That way, they argue, it would offset the requirement that insurers take all comers regardless of their health status.

What leaders are saying about it

Here’s a sampling of what some powerful lawmakers and interest groups are saying about Monday’s ruling, taken from prepared statements issued by press secretaries and media-relations departments. I edited them for length considerations only:

Sen. Tom Harkin, Democrat of Iowa and Chairman of the Senate Health, Education, Labor and Pensions Committee: “Although I am pleased he did not move to halt the implementation of the law, Judge Vinson is wrong in his assessment of the individual mandate. When people seek medical care without health insurance and don’t pay for it, they aren’t ‘opting out’ of the health care market. Instead, it adds more than $1,000 per year to the premiums of American families who act responsibly by having coverage. This clearly affects interstate commerce and is thus within Congress’ power to regulate.”

Rick Perry, governor of Texas and Chairman of the Republican Governors Association: “Today’s ruling represents a victory in the ongoing effort to end federal intrusion into the lives of every American through this one-size-fits-all approach to health-care reform. I applaud the judge’s decision, which affirms that the federal government’s attempt to force individuals to buy government-approved health insurance is an egregious violation of our constitutional rights.”

Sen. Patrick Leahy, Democrat of Vermont and Chairman of the Senate Judiciary Committee: “I have long believed in the constitutional authority of Congress to enact the Affordable Care Act. The language and spirit of the Constitution provides for such action, as does judicial precedent and prior acts of Congress to protect hardworking Americans in the national health-care market and promote the general welfare. At a hearing later this week, the Judiciary Committee will hear compelling testimony on the constitutionality of the Affordable Care Act…. Political opponents of the Affordable Care Act are intent on doing in the courts what they could not do in Congress by rolling back these important protections. As these challenges move through the courts, I hope that the independent judiciary will recognize Congress’s core constitutional authority and the court’s long-standing precedents.”

Karen Harned, executive director, National Federation of Independent Business’s Small Business Legal Center: “NFIB is extremely pleased with Judge Vinson’s decision. NFIB joined this case to protect the rights of small-business owners to own, operate and grow their businesses free from unnecessary government intervention. The individual mandate, which forces citizens to purchase government-approved health insurance, undermines this core principle and gives the federal government entirely too much power. We are delighted Judge Vinson agreed with NFIB and the states on this critical issue.”

Debra L. Ness, president of the National Partnership for Women & Families: “Opponents are spending millions of dollars to challenge this law when they could be joining the effort to improve care for those who need it most. If they succeed, we will go back to the days when people with pre-existing conditions could not get coverage, insurers dropped consumers or imposed caps when they got sick, and gender discrimination pervaded the insurance market. That is not what America wants and not what America needs. This ruling must be overturned.”

Nikki Haley, Republican Governor of South Carolina: “We have long argued that, among its many other flaws, the national health-care law is unconstitutional, something that is now increasingly clear to all. South Carolina must take steps to avoid this unconstitutional infringement – one we do not want and cannot afford. We can improve health care in our state without this massive mandate from Washington, and that’s what our Administration, working with the General Assembly, will do.”

Larry McNeely, health-care advocate, U.S. Public Interest Research Group: “Consumers and small businesses would face significantly higher insurance premiums if higher courts ultimately uphold Judge Vinson’s ruling to reverse last year’s federal health-care law. According to a recent report from U.S. PIRG, The Cost of Repeal, consumers who purchase their own insurance would face up to 20% higher premiums in the event this law [is invalidated] and the per-employee cost of providing employer-sponsored insurance would be $3,000 a year higher, by the end of the decade. However, rollback of the law is far from inevitable….The parties to this suit should dedicate the time, energy and precious taxpayer dollars they are now wasting on this lawsuit toward finding real solutions to the growing threat which health-care costs pose to their states’ economies.”

DeAnn Friedholm, director, Consumer’s Union’s health-reform campaign: “Today’s decision demonstrates once again that federal judges are divided on the constitutionality of the Affordable Care Act and the Supreme Court will ultimately have to decide. But as courts continue to wrestle with the constitutional question, consumers continue to enjoy new protections. We will keep up our efforts to inform Americans about their new rights and important changes that rein in insurance industry abuses.”

Sen. Mitch McConnell, Republican of Kentucky, Senate Minority Leader: “This ruling confirms what Americans have been saying for months: The health spending bill is a massive overreach and Democrats ‘exceeded the bounds’ of Congressional authority under the Constitution in passing the law with the individual mandate. Rather than penalizing Americans if they don’t buy a particular product that Washington decides is best, we should repeal this health-spending bill and replace it with commonsense reforms that will actually lower costs, prevent unsustainable entitlement promises and make it easier for employers to start hiring again.”

U.S. Rep. Nancy Pelosi, Democrat of California, House Democratic Minority Leader: “Today’s court ruling is one of many. While some are using every means to undermine patients’ rights, we will continue to protect the millions of parents, children, students, seniors who rely on Medicare, and small businesses who are benefiting from reform and will benefit soon. We strongly believe that health reform is constitutional, and is consistent with longstanding precedents of the Supreme Court.”

About Health Matters

Health Matters is a blog-style round-up of news and analysis concerning consumer health and the business of health care. The lead writer is MarketWatch reporter Kristen Gerencher, who also writes the Vital Signs column. Andrea Coombes and Jonathan Burton contribute editing. Gerencher won a 2006 explanatory journalism award from the Society of Professional Journalists-Northern California for a series she did on health savings accounts.